Sleeping can be challenging for all of us. If you’re a parent, you know the struggle to get your kids to go to sleep on time and wake up in the morning. A world ruled by the coronavirus pandemic hasn’t made things any easier.
We got the chance to talk to W. Chris Winter, M.D., board-certified neurologist and internationally recognized sleep medicine specialist about his new book The Rested Child: Why Your Tired, Wired, or Irritable Child May Have a Sleep Disorder — and How to Help.
The book dropped last week and aims to solve the long-asked question, “why isn’t my kid sleeping?” Tens of thousands of children each year are diagnosed with diseases or learning disabilities. But what if the root cause of their concerns is actually an undiagnosed sleep disorder? Parents won’t want to sleep on this comprehensive guide to sleep disorders and children’s sleep needs.
Slumber Yard spoke with Dr. Winter about all things sleep. Read his answers below.
As a neurologist and sleep specialist, what tips do you have for parents to help their children sleep?
We are probably putting a little too much pressure on ourselves as parents if we think we are somehow responsible for training our kids to sleep. The truth is, they already know how to do it, and we’re doing primitive versions of it before we ever met them. What we are really doing is just creating some boundaries or parameters within their lives so that their brains begin to understand when the appropriate times are for everything their circadian rhythms control (including rest/sleep). When I used to coach Little League baseball, every kid who showed up knew how to pick up a ball and throw it or grab a bat and swing it. My job was to help guide them as to the appropriate times in which to do those actions and maybe refine the actions a little along the way.
What things might parents be doing that are hurting their children’s ability to sleep?
I think focusing a lot of attention on bedtime is problematic. The bedtime needs to be relaxed and stress-free. Unfortunately, this is far from the situation in many homes. Every child sleeps. It’s impossible not to, so relax about the speed with which your child nods off and focus more on making sure they are up at or before the designated wake time.
I also think we put way too much emphasis on sleep/unconsciousness and teach kids that being in bed awake is something to fear or fix. Teaching kids to embrace being in bed awake (and not run from it) is essential. Being awake in bed is a great time for reflection, meditation, breathing, praying, planning out an English paper, reflecting on how you handled a situation, etc. We always speak so fondly of “daydreaming”…we should do the same for nightdreaming. Keep in mind that sleep can be hard to control. Resting is always under a child’s control.
You go into great depth about the rising numbers of ADHD diagnoses. How do you view the relationship between sleep disorders in children and ADHD?
I view ADHD as a real and primary diagnosis. I view sleep disorders as problems that can create symptoms that mirror a diagnosis like ADHD. There are lots of reasons why a car won’t start, and many of them look like a dead battery. A good mechanic is going to diligently evaluate all of the causes of a car not starting before proclaiming that the battery should be replaced. I think we as physicians should diligently evaluate all of the causes of inattentiveness before we declare a child as having an ADHD diagnosis.
Sleep is directly connected to attention. We know from studies that just a few days of restricted sleep can create significantly higher lapses in attention/careless mistakes. Ensuring good quality sleep is how we can make sure we are setting a child up to perform maximally!
How prevalent are sleep disorders in children?
They are extremely prevalent. Two out of every 3 kids will experience a sleep problem or disorder during childhood/teen years. That’s 66%. Let’s say the number is inflated and cut it in half (33%… 1 out of 3 kids). Compare that number to other pediatric disorders: diabetes .25%, depression 4-5%, ADHD 9%. Obesity, which has been called an epidemic by many, is only 18%-19%. The scope we are talking about is massive.
How are sleep-related issues like poor performance in school or trouble focusing becoming more prevalent “post” pandemic?
Outside of the crippling stress and anxiety kids feel in this time of uncertainty, the pandemic has:
- Virtually eliminated or dramatically curtailed exercise in organized ways. My son is a rower. His first day back is literally today.
- Kids have lost the structure of their day and the zeitgebers (time cues) their brains use for establishing a healthy circadian rhythm. Loose wake times, eating anytime during the day, zero genuine peer interaction, etc.
- Dramatically increase technology/screen time which is nightly detrimental to sleep.
- No ‘movement’ during the day. Kids just stay in their bedrooms.
- Skewed light exposure during the day. Our brains use light levels and changing color characteristics to regulate sleep. Screens and bedroom lights do not provide the necessary cues for healthy sleep.
- Poor parental modeling (their sleep is a mess too).
- If kids have had COVID, it can directly affect sleep and levels of fatigue.
- A lack of activity during the day reduces the production of the sleep-promoting chemical adenosine in the brain.
- There are so many ways the changes in this post-pandemic world have hurt the sleep of kids and teens.
Too Long, Didn’t Read?
Childhood sleep disorders are extremely prevalent yet widely unknown to parents. If you’re struggling to help your child learn healthy sleep practices, talk to your doctor. They will be able to help you uncover the root of the issue and help your child sleep better.
As a parent, you want the best for your child. If your child is exhibiting any of these signs, they might not be getting enough sleep:
- If they are having a hard time expressing emotions. They are fussy or irritable.
- A hard time paying attention.
- Mood swings or impulsivity.
- A drop in cognitive processing and reaction time.
Helping your child establish a healthy sleep schedule isn’t just about having a bedtime or staying in bed. Dr. Winter has a ton of insights to offer; if you haven’t yet, check out his book. It has everything you need to know about turning your kid into a rested child.
W. Chris Winter, M.D.
Dr. Christopher Winter has practiced sleep medicine and neurology in Charlottesville, Virginia since 2004, but has been involved with sleep medicine and sleep research since 1993. As the owner of Charlottesville Neurology and Sleep Medicine, CNSM Consulting and the Medical Director of the Martha Jefferson HospitalSleep Medicine Center, Dr. Winter is not only an active participant in patient care, but a dynamic speaker and researcher on the science of sleep.